Oral Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

Osteointegrated implants for prosthetic based ear/eye reconstruction: a 15 years case series at Waikato DHB (1385)

Eric Tan 1 , Luxi Sun 1 , Sarah Cox 1 , Taz Singh 2 , Maria Mani 3
  1. Plastic Surgery, Waikato DHB, Hamilton, Waikato, New Zealand
  2. Maxillofacial Surgery, Waikato DHB, Hamilton, Waikato, New Zealand
  3. Surgical Services, Plastic Surgery , Uppsala University, Uppsala, Sweden

Introduction: Osteointegrated implants (OII) based reconstruction of the ear and eye has been reported to be a good alternative to autologous reconstruction.

We would like to share our 16 years case series of OII in Waikato DHB.

Methods: A list of patients treated in prosthetic department from March 2004 to February 2020 were generated and a standardised proforma was used for data collection.

Results: A total of 59 patients with 89 prosthesis for ear and one for eye were included in this case series. 47 patients had a one stage reconstruction. 

Mean age was 36 years with the youngest patient being 2 and oldest 88 years. 51 patients are Pakeha, seven Maori and one has Fijian ethnic background.

Male: Female ratio was 26:33. Average follow up time was 23 months (range 11 months to 35 months).

 

Seven patients were current smoker at the time of OII surgery, 2 ex-smoker (6 months or more) and the remaining were non-smokers.

 

Forty-five cases were for congenital defects (41 for isolated ear congenital abnormality and four as part of syndromic pathology). Six were performed for chronic infection resulting in loss of major subunits of ear(s), seven for neoplastic pathology and one for external ear trauma.

Forty eight were for functional hearing purpose and 41 for craniofacial implants for external ear reconstruction.

 

Infection was reported in 18 patients with 15 treated with antibiotics alone. Three out of 89 prosthesis (3%) required removal and washout of insertion site. There was no statistical difference in infection rates between different indication groups.

All 7 smokers developed infection of implants while 11 of 52 non-smoker/ex smoker developed infection . In radiotherapy group 2 out of 13 implants became infected.

 

Conclusion: Infection rate is low in our case series with smoking being a high risk factor for this.